Provider Demographics
NPI:1780204966
Name:NOWLIN, AMANDA LYNN (LPC-MHSP TEMP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:NOWLIN
Suffix:
Gender:F
Credentials:LPC-MHSP TEMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4065 HUNTERS POINT PIKE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1192
Mailing Address - Country:US
Mailing Address - Phone:615-426-5212
Mailing Address - Fax:
Practice Address - Street 1:4065 HUNTERS POINT PIKE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1192
Practice Address - Country:US
Practice Address - Phone:615-426-5212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN521500101YS0200X
TN4470101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool